Frequency and risk factors for malnutrition in children undergoing general anaesthesia in a French university hospital.

<bold>Background: </bold>Malnutrition is often underdiagnosed in hospitalised children, although it is associated with postoperative complications, longer hospital lengths of stay and increased healthcare-related costs.<bold>Objective: </bold>We aimed to estimate the frequency of, and identify factors associated with, malnutrition in children undergoing anaesthesia.<bold>Design: </bold>Cross-sectional observational study.<bold>Setting: </bold>Paediatric anaesthesia department at the University Children's Hospital, Bordeaux, France.<bold>Participants: </bold>A total of 985 patients aged less than 18 years.<bold>Main Outcome Measures: </bold>Anthropometric measurements, American Society of Anesthesiologists physical status classification score and the Pediatric Nutritional Risk Score (PNRS) recorded at the pre-anaesthesia evaluation.<bold>Results: </bold>When assessed as a Waterlow index less than 80%, malnutrition was present in 7.6% children. This increased to 8.1% of children assessed by clinical signs and to 11% of children when defined by a BMI less than the third percentile. In a univariate analysis, children with a BMI less than the third percentile were more often born prematurely (22.4 vs 10.4%; P = 0.0008), were small for gestational age at birth (18.4 vs 4.5%; P < 0.0001), were admitted from the emergency department (12.0 vs 5.6%; P = 0.02), had a high American Society of Anesthesiologists score (P < 0.0001), or had a high Pediatric Nutritional Risk Score (P < 0.0001). Presence (P = 0.01) and type (P = 0.002) of chronic disease were also associated with malnutrition. In the multivariate analysis, a premature birth, a lower birth weight and a higher Pediatric Nutritional Risk Score were significantly associated with a higher odds of malnutrition when defined by BMI.<bold>Conclusion: </bold>All children should be screened routinely for malnutrition or the risk of malnutrition at the pre-anaesthesia visit, allowing a programme of preoperative and/or postoperative nutritional support to be initiated. We suggest that as well as weight and height, BMI and a pediatric nutritional risk score such as PNRS should be recorded routinely at the pre-anaesthesia visit. [ABSTRACT FROM AUTHOR]